Dr. Miguel A. Lipka

Nerve Injury

Nerve injury can sometimes result from dental treatments such as dental injections, root canals, insertion of dental implants and removal of teeth or other surgical treatments. These injuries affect the trigeminal nerve. The trigeminal nerve is responsible for sensation in the face. It also has certain motor functions (biting, chewing, and swallowing).

Trigeminal neuralgia (TN) is a neuropathic disorder characterized by episodes of intense pain in the face that originates in one of the three trigeminal nerves. This pain may be felt in any or all of the following: the ear, eye, lips, nose, scalp, forehead, cheeks, teeth, or jaw and alongside of the face, or in some cases, the left index finger.

It is estimated that 1 in 15,000 people suffer from trigeminal neuralgia, although the actual figure may be significantly higher due to frequent misdiagnosis. In a majority of cases, TN symptoms begin appearing after the age of 50, although there have been cases with patients being as young as three years of age. It is more common in females than males.

Nerve injuries affecting the trigeminal nerve can cause episodes of intense, stabbing, electric shock-like pain in the areas of the face where the branches of the trigeminal nerve are distributed, including the lips, eyes, nose, scalp, forehead, upper jaw and lower jaw.

Trigeminal nerve injuries can be extremely distressing for patients. Although the majority of patients regain normal sensation and function within a few weeks or months, some are left with abnormal sensation or pain, which can cause problems with speech and chewing.

While medications may be used to manage many cases of nerve injury, they do not provide a permanent solution. Some patients may require surgery. Some of surgical approaches for TN, include:

Nerve decompression

Nerve repair from inside and outside of the mouth

Nerve grafting using nerves from the neck and foot

Percutaneous rhizotomy, a procedure that destroys part of the nerve that causes pain